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1. Adequate Planning and Preparation are Essential

Administrators must take time to plan the implementation of the transition from ICD-9 to ICD-10 coding. The medical authorities in Canada initially underestimated the volume of work needed for full implementation of ICD-10. Hence, budgets and timelines were seriously underestimated because of unavoidable delays and many unknown variables that were not even anticipated at the beginning. For instance, when Canada rolled out its ICD-10 system, the Windows-based software for coding was just making its debut. Coders had to grapple with the new code set as well as the challenge of switching from manual recording to the use of Windows-based desktop software. This led to so much inefficiency because the initial magnitude of process changes was underestimated. 

2. Physicians Need to Be Involved Early

U.S. physicians must understand the scope of the ICD-10 coding from the onset. This may be achieved through comprehensive physician documentation training. Adequate training will enable them to select the systems and tools that best work for them. Physicians also need to build up their documentation skills early so that medical coders can assign codes accurately. Such training should even start in medical school. Unfortunately, many medical schools have not realized the importance of this type of training and dedicate only a few hours to detailed physician documentation training. Better training will enhance the productivity of the coders and the overall medical reporting system. 

3. Anticipate Budget Overruns and Project Extensions

From the Canadian experience, and with the complete paradigm shift involved in moving from ICD-9 manual coding to the computerized and complex ICD-10 coding system, every hospital administrator should expect delays in project completion time. And the transition will cost more than expected—by at least 25 percent more. Since you will experience delays, it means the best time to start planning and training for your ICD-10 project is now. 

4. Understand the Nature of the ICD-10 Learning Curve

More training is required for coders if they are going to achieve anything close to 70 percent productivity within the first year of implementation of the ICD-10 coding system. In Canada, the coders that were able to excel had to take extra responsibility for their professional development. The initial mandatory training was not adequate. Medical coders need to be able to use mobile educational solutions and specialized tools in their spare time to learn the coding faster and better contribute to their organizations. 

To begin preparations for the successful implementation of this medical coding system in your healthcare facility, consult an ICD-10 project implementation and training firm. 

Provident Consulting

Why ICD-10?

There are various reasons why a transition to a newer coding system is in order. ICD-9 has been the cornerstone of morbidity and mortality coding for 30 years and areas for improvement have been identified. The older system is no longer robust enough to serve the health and medical needs of the modern-day healthcare system. Clinical content is far from accurate, and there is limited data about medical conditions and procedures. ICD-9 also has a insufficient number of codes, and experts admit that the coding structure of the older system is too restrictive.

A move toward ICD-10 is particularly crucial in the U.S., where coding for mortality data is not on par with the rest of the world.ICD-10 is an improved system that is designed to enhance the quality of data for tracking public health conditions, provide data for improved medical research, allow for more accurate clinical decisions, and make fraud and abuse easier to detect.

What provider changes can you expect?

Providers face a lot of work in order to comply with the requirements of the new code. They can expect a reduction in productivity as entire hospitals and clinics try to cope with the changes. There may also be accompanying risks of denials as part of the growing pains that come with getting used to a new coding system.

Providers can expect to make changes in the areas of analysis programs, data extraction programs, how they use data tables, and reporting. Familiarity with new matrices, table formats, and new terminologies will be required and can be accomplished by training all staff and personnel that handle patient data. Training and Transition Tips With the switch to a newer code comes the need for additional education and training on data management and clinical documentation. Hospitals and practices must educate physicians and staff on how to work with the new set of codes. Physician employers and hospital administrators can work with hospital administration consulting firms who can help them formulate training programs and timelines that will get them ready for the transition in time.

Important steps include the development of a project plan, setting up a managing team to lead the entire hospital or the clinic through the process of transition by implementing the plan, assessment of training and education needs to ensure that resources are utilized in the most efficient way possible, and conducting post-implementation follow-ups to ensure that all systems are working seamlessly with the new code.

Contact Provident Consulting to make sure you're ready for the 2015 ICD-10 transition.